Honorable John BoehnerPage 2subsequent years; consequently, we expect that repealing that legislationwould increase budget deficits.The projected increase in deficits will not be exactly the same as thereduction in deficits that was originally estimated to result from the enactedlegislation. As will be discussed in the detailed estimate that isforthcoming, a number of developments have occurred since CBO and JCTproduced the cost estimate for the March 2010 legislation (shortly before itwas enacted). In particular:
The original estimate was based on the projections of economicconditions, health care costs, federal spending and revenues, andother factors that CBO published in March 2009. The economicoutlook is now somewhat different, and CBO has made a number of technical changes to its spending and revenue projections related tohealth care programs.
Some of the funding provided by the legislation enacted last Marchhas been obligated or spent, and some regulations implementingaspects of that legislation have been promulgated. The budgetaryimpact of repealing that legislation depends on the extent to whichrepeal would affect those actions; because an estimate of repealwould assume enactment around the end of this fiscal year, nosignificant budgetary effects would occur in fiscal year 2011.(However, such effects would occur if H.R. 2 was enacted wellbefore the end of the fiscal year.)
Subsequent legislation has already modified the laws enacted lastMarch. Specifically, the Medicare and Medicaid Extenders Act of 2010 (P.L. 111-309) increased the amount that could be recoveredfrom enrollees in insurance exchanges whose actual income in a yeardiffered from the figure used to determine their tax credit for healthinsurance premiums. That legislation was estimated to reduce net
For example, in
The Budget and Economic Outlook: An Update
that was published in August2010, CBO noted that identifiable changes in the estimated effects of some of the provisions of thelegislation had reduced projected outlays over the 2010–2019 period by about $11 billion andincreased projected revenues by about the same amount (see Box 1-1 on page 6). For manyaspects of the legislation, however, distinguishing the effects of economic and technical updateson the budgetary impact of PPACA and the Reconciliation Act from their effects on theprojections that would have been made under prior law is difficult. Therefore, developing thebaseline projections in August did not automatically result in an estimate of the effect of PPACAand the Reconciliation Act under the economic and technical assumptions of that baseline.